AMH、EMAb、tPA联合检测在子宫内膜异位症患者预后评估中的价值研究  

Value of Combined Detection of AMH,EMAb and tPA in Prognostic Evaluation of Patients with Endometriosis

作　　者：李妘[1] 孙秀利 王静 LI Yun;SUN Xiu-li;WANG Jing(Department of Gynecology,Hanzhong Central Hospital,Hanzhong,Shaanxi 723000,China;Department of Gynecology,Shaanxi Provincial Tuberculosis Control Hospital the Fifth People's Hospital of Shaanxi Province,Xi'an 710105,China;Department of Gynecology and Oncology,Shaanxi Cancer Hospital,Xi'an 710061,China)

机构地区：[1]汉中市中心医院妇科,陕西汉中723000 [2]陕西省结核病防治院(陕西省第五人民医院)妇科,西安710105 [3]陕西省肿瘤医院妇瘤科,西安710061

出　　处：《解放军医药杂志》2021年第11期93-96,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省重点研发计划项目(2018SF-207)。

摘　　要：目的探讨抗苗勒管激素(AMH)、抗子宫内膜抗体(EMAb)、组织型纤溶酶原激活物(tPA)联合检测在子宫内膜异位症(EMS)患者预后评估中的价值。方法将2015年1月—2019年1月在本院行腹腔镜检查或开腹手术治疗的141例EMS患者作为异位组,另选取本院同期体检健康女性152例作为对照组。比较2组AMH、EMAb、tPA水平,随访1年比较自然妊娠与未妊娠患者AMH、EMAb、tPA水平,采用受试者工作特征(ROC)曲线分析AMH、EMAb、tPA联合检测对EMS预后的评估价值。结果异位组AMH、EMAb水平高于对照组,tPA水平低于对照组(P<0.01)。自然妊娠患者AMH、EMAb水平低于未妊娠患者,tPA水平高于未妊娠患者(P<0.01)。AMH、EMAb、tPA联合检测评估EMS预后的敏感度(0.925)、特异度(0.948)、曲线下面积(0.971)均显著高于单一指标检测(P<0.01)。结论AMH、EMAb、tPA在EMS患者体内异常表达,三者对患者术后自然妊娠作用显著。临床可通过三者联合检测评估EMS患者预后,以做到早诊断、早治疗,尽可能提高患者妊娠率。Objective To explore the value of combined detection of anti-mullerian hormone(AMH),anti endometrial antibody(EmAb)and tissue plasminogen activator(tPA)in prognostic evaluation of patients with endometriosis(EMS).Methods A total of 141 patients with EMS who had undergone laparoscopy or open surgery between January 2015 and January 2019 were selected as ectopic group,and other 152 healthy women undergoing physical examinations at the same period were selected as control group.Levels of AMH,EMAb and tPA were compared in two groups.Levels of AMH,EmAb and tPA were compared after 1-year follow-up between patients with natural pregnancy and those without natural pregnancy.The value of combined detection of AMH,EMAb and tPA in evaluation of prognoses of EMS patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with those in control group,AMH and EmAb levels were significantly higher,while tPA level was significantly lower in ectopic group(P<0.01).Compared with those in patients without natural pregnancy,levels of AMH and EmAb were significantly lower,while tPA level was significantly higher in patients with natural pregnancy(P<0.01).The sensitivity(0.925),specificity(0.948)and area under the ROC curve(0.971)of the combined detection of AMH,EmAb and tPA were significantly higher than those by single index detection(P<0.01).Conclusion AMH,EmAb and tPA are abnormally expressed in patients with EMS,and they have significant effects on postoperative natural pregnancy.The prognoses of patients with EMS can be evaluated through the combined detection of the above three indexes so as to achieve the early diagnosis and treatment and improve the pregnancy rate as much as possible.

关 键 词：子宫内膜异位症 抗苗勒管激素 抗子宫内膜抗体 组织型纤溶酶原激活物 预后 

分 类 号：R711.71[医药卫生—妇产科学]